Is high tech best?

Rather than writing down your symptoms, doctors are now recording them electronically.

With electronic medical records, doctors go down a list of bullets and check off the correct symptoms.

As health care systems are changing, some doctors are wary of the future.

“People do not like the loss of personal time with the doctor in exchange for regurgitating data for computer systems,” said Dr. Rebecca Love, who practiced at Jones Family Practice in Shelby. “The doctor-patient interview process is a skill. It’s like telling a carpenter to not use his chisel and to use a chainsaw.”

Love is leaving her private practice after 13 years due to these changes with electronic medical records.

Electronic medical records are replacing paper documents. Vital signs, symptoms and diagnoses are now being recorded via iPads.

“My concern now is that it affects the doctor-patient process. You have to listen, not concentrate on putting information into a computer,” she said. “Diagnosis is a human talking to you, but you have to watch them and their body language to understand what’s wrong. It’s not a recipe or an algorithm.”

Practices purchase the hardware and have a monthly fee for the software used in the electronic record program. An incentive of $44,000 over three years is paid to doctors who prove they were using it in a meaningful way for at least three months by the end of 2012, Love said.

“If a doctor chose not to go to the expense and convert to electronic health records by 2014, they will be penalized with reduced reimbursements from Medicare,” she said.

A medical journal study earlier this year found that computerized patient records encourage doctors to order expensive tests more often -- and that electronic records may not cut health care costs as advertised.

The US government has spent more than $30 billion to encourage a shift to digital records, mostly through incentive payments to hospitals and doctors that were authorized in 2009 as a part of President Obama's economic stimulus law.

But according to the report from the US Inspector General's Office and US Department of Health and Human Services, not all doctors are qualifying for the incentive payments.

'It cost our practice quite a bit of money'

Love isn’t the only doctor turned off by the electronic shift. Bryan Young entered early retirement, leaving his position at Shelby Surgical Associates.

“I was going to retire this upcoming spring but bumped it up after our office converted to electronic records,” Young said. “It’s tedious and burdensome. It cost our practice quite a bit of money to get the new computer system, and we had to hire more personnel to enter data so we could get patients into the doctors. It really slowed the flow of patients.”

Young is now the medical director for the physician's assistant studies program at Gardner-Webb University.

“Most of our patients didn’t like the records,” he said. “Most of the complaints were that the doctor looks at his computer and not me.”

And electronic records aren't the only change bothering doctors.

Along with the electronic records, hospitalist programs were developed. Hospitalists care for patients while they are in the hospital, rather than their primary doctor.

“Patients don’t like that their family doctor isn’t there to see them in the hospital,” Love said. “Our schedule is easier because of it, but doctors didn’t choose that. We are accustomed to being on call and going to the hospital.”

The changes date back to the late 1990s -- far before Obamacare.

“It’s political and about money,” Love said. “The government is trying to control Medicare as more and more people are getting to the Medicare age. For example, it doesn’t matter if you stay in the hospital for two days or two weeks, the hospital gets paid the same amount for your stay.”

Doctors also now have to answer for why they are giving prescriptions.

Electronic records have been used by the military for several years, but now doctors are required to make the switch by 2014 or face penalization.

Jones Family Practice started using digital equipment in August. The office was closed on Fridays while they were training. But being closed during those hours isn’t the only expense for the offices.

While electronic medical records should be more efficient, it takes doctors longer, Love said.

“Patients can’t come in as quickly, because it takes longer to record with the records,” she said. “People think it’s neat because it’s high-tech, but it’s personally starting to make me get behind. There is a lot of room for error, too, because you can’t change other doctors' mistakes.”

Love will leave the private practice at the end of the month and will work at Hospice Cleveland County as leader of Palliative Care.

“Private practices are getting purchased by hospitals because it’s too expensive for them to continue privately,” Love said. “It’s a dire situation if we go blindly forward.”

The Associated Press contributed to this report. Reach Jessica Pickens at 704-669-3332 or jpickens@shelbystar.com . Follow on Twitter at @StarJPickens.